Intervertebral disc space infection and osteomyelitis due to Hemophilus species: report of two cases and review.

Vertebral osteomyelitis and intervertebral disk space infections in adults are most often caused by Staphylococcus aureus or Escherichia coli. Despite an increasing number of cases caused by other gram-negative bacteria, documented spinal infections with Hemophilus species remain exceedingly rare. All prior cases have involved the lumbar spine between the L2 and L4 levels. None has required surgical decompression or stabilization. We report two adult patients with intervertebral disk space infections and osteomyelitis outside the lumbar region. One patient, who had a Hemophilus influenzae infection of the T9-T10 disk space, was successfully treated with intravenous antibiotics and external bracing. Another patient, who had a Hemophilus aphrophilus infection that destroyed the C5-C6 disk space and adjacent vertebral bodies, required surgical debridement and stabilization in addition to antibiotic therapy and halovest immobilization. Neither patient had a significant underlying illness or extra-spinal source of infection. The clinical features and spinal levels affected in these two patients have expanded our knowledge of the spectrum of disease caused by Hemophilus species.